Why might someone undergo a transesophageal echocardiogram instead of a transthoracic echocardiogram?

A transesophageal echocardiogram (TEE) is often selected over a transthoracic echocardiogram (TTE) primarily to achieve superior visualization of the heart's posterior structures, such as the left atrium, mitral valve, and structures near the aorta. The transesophageal approach allows the ultrasound transducer to be positioned in the esophagus, which is located closer to the heart than the chest wall used in TTE. This proximity minimizes interference from overlying tissues, such as the lungs and ribs, allowing clearer and more detailed images of these critical heart components that might otherwise be obscured in a transthoracic study.

In contrast, while options like obtaining a wider view of the heart or increasing Doppler sensitivity can sound advantageous, they do not highlight the primary reason for choosing a TEE over a TTE, which is the detailed visualization capabilities for specific areas of the heart. Avoiding sedation would not be a reason for opting for TEE, as sedation is typically necessary for comfort during the procedure.